Typically, an intramedullary nail is placed into the intramedullary cavity of physically compromised osseous material in order to maintain proper alignment of the material for optimal healing. The intramedullary nail is then secured by screws to allow support of the bone so that the patient can use the appendage during healing. Previous intramedullary nails had holes on both the distal and proximal ends for the insertion of fixtures, such as screws, that go through the intramedullary hardware and compromised osseous material. The holes that are closest to the point of nail insertion are called the “proximal” holes and those furthest away are the “distal” holes. The most commonly used system for securing an intramedullary nail uses an external guide or jig to find the proximal holes in the nail. With the assistance of the external guide or jig, the surgeon then drills through all of the tissue surrounding the bone and into the bone. For minimal damage and maximal healing, the fixture holes that are drilled into the leg and the bone must precisely align with the insertion holes in the intramedullary hardware so that the hardware can be secured with respect to the medullary canal.
Various types of external guides and jigs have been proposed to assist in the insertion of intramedullary hardware, such as shown in U.S. Pat. No. 4,733,654 A1 to Marino and U.S. Pat. No. 5,776,194 A1 to Mikol et al. Such external guides and jigs may be temporarily attached to the proximal end of the intramedullary nail to help align the bone fixtures and/or the drill to the receiving opening in the intramedullary nail. While such external guides and jigs are helpful to achieve proper alignment, their accuracy decreases they proceed from the proximal end to the distal end of the intramedullary nail. Additional solutions are needed, especially for attaching the distal end of the intramedullary nail to a distal osseous material fragment.
There are currently no effective external systems for finding the distal holes of an intramedullary nail. As mentioned above, guides for the distal hole become less reliable as distance from the proximal end of the intramedullary nail increases, particularly if any bending of the intramedullary nail has occurred. A commonly used procedure involves repeated x-raying of the patient to find the hole and then drilling through the leg into the bone. Another method for securing the distal end of the intramedullary nail is to drill the receiving opening into the intramedullary nail only after the intramedullary nail is placed into the bone, as disclosed in U.S. Pat. No. 5,057,110 A1 to Kranz et al. Bioresorbable materials, however, are not as strong as metals, leading to an intramedullary nail that is weaker than desired and has a weaker attachment than desired.
Continuing, additional problems occur with intramedullary nails using bioresorbable materials due to the healing requirements of a bone with respect to the strength and rigidity of the intramedullary nail. U.S. Pat. No. 4,756,307 A1 to Crowninshield and U.S. Pat. No. 4,338,926 A1 to Kummer et al. disclose an intramedullary nail with bioresorbable portions to weaken the nail relative to the bone over time. These intramedullary nails, however, forsake the use of a transverse bone fastener to achieve the benefit of the bioresorbable portions.
Finally, while most intramedullary nails remain in the patient's leg throughout their lifetime, the nail does occasionally need to be removed due to complications. The complications usually arise from the presence of the screws holding the nail in place. When the removal of the nail is necessary the physician must repeat the insertion procedure to find the location of the screws and drill into the leg again.
It would thus be advantageous to provide an intramedullary nail and related portions and/or components that overcomes the above-noted shortcomings.